PROJECTSUMMARY Thequalityofcaredeliveredtopatientswithseriousmentalillness(SMI)lagswellbehindthepotentialtotreat thesepatients,givenanarrayofefficaciousevidence-basedtreatmentsavailable.Fragmentationofcareand rigid,poorlyalignedpaymentapproachescontributetoinadequatephysicalandmentalhealthcareforpatients withSMI.Newcontractingandpaymentstrategiesaimtoincreasethequalityandvalueofcareforpatients withSMIusingfinancialincentivesandexplicitqualityofcarebenchmarks.Theseemergingstrategieshold promiseforincreasingtheefficiencyandeffectivenessofcareforpatientswithSMI,oneoftheobjectivesin the2015NIMHStrategicPlanforResearch.Despiteincreasingadoptionofnewpaymentstrategiesbypublic insurers,whichinsureadisproportionateshareofpatientswithSMI,scantevidencedescribeswhetherand howthesechangesarelinkedtoqualityofcareandoutcomesforthisvulnerablegroup,andevenlessis knownaboutcontractororganizationfeaturesthatmayimprovequalityofcareforpatientswithSMI.New healthcarepaymentanddeliverycontractshavemanygoals:encouragingcoordinationofcare,promoting deliveryofcareinthemostappropriatesetting,improvingpopulationhealth,andcontaininghealthcarecosts. Inthisproposedresearch,usingthestartdateofnovelpaymentcontracts,wewill1)examinehowemerging contractsbetweenprovidersandinsurersaddresshealthcareforpatientswithSMI;?2)estimatehowthe qualityofcareandoutcomesforpatientswithSMIchangewithpaymentcontractdesignsandorganizational strategies;?and3)estimatehowpopulationhealthmeasuresareassociatedwithcontractdesignsand organizationalstrategiestargetingphysicalandmentalhealthcareforpeoplewithmentalillness.Tocomplete theresearch,wewilldevelopandfieldamentalhealth-focusedwaveofanongoingsurveyofhealthcare providerorganizations(Aim1).Wewilllinkthesenewsurveydataoncontractdesignsandmentalhealth- specificorganizationalstrategiestopatient-leveladministrativeclaimsdata(Aims2and3)tobetterunderstand theimplicationsofemergingcontractsforqualityofcareandpopulationhealthoutcomesforpeoplewithSMI. Theproposedresearchwillhelptotailoremergingpaymentcontractsandorganizationalstrategiestomeetthe needsofpopulationswithmentalillness.